How to choose the right contraception

What it is

Female natural methods of contraception involve monitoring physical changes that occur throughout the menstrual cycle, in order to predict when you are fertile. Unprotected sex is then avoided during this time, and you may either abstain from sex or use another method of contraception, such as a condom.

How it works

The changes that may be monitored include body temperature, consistency of cervical mucus, position and texture of the cervix, mood changes, mid-cycle spotting of blood or pain at ovulation, breast sensitivity, acne and other skin changes.

As some women seem to ovulate at different times in each cycle, and a few women seem to ovulate more than once in a cycle, its reliability is difficult to assess. With careful use, fertility awareness can be as effective as barrier methods of contraception - failure rates are usually quoted as ranging from 2% - 20%.

Pros

• No side-effects.
  
• Allows an increased awareness of fertility.
  
• Allows a woman to feel in control.
  
• More acceptable to some couples on religious grounds.
  

Cons

• Women need personal tuition from a trained teacher, as the techniques and calculations involved are complex, and need to be fully understood if the method is to work as effectively as possible.
  
• Requires full commitment.
  
• Monitoring must occur throughout the menstrual cycle.
  
• Some women find it distasteful to examine cervical mucus.
  
• Cervical mucus can be confused with semen or spermicides.
  
• A mild fever may mimic the temperature shift.
  
• Recent research suggests the timing of ovulation is not as predictable as previously thought. At least 10% of women seem to be fertile on any given day between days six and 21 of their cycle (the first day of bleeding equals day one), and up to 6% are potentially fertile even on the day their next period was due.